Music therapy may improve schizophrenia symptoms

The preliminary research, published today in the British Journal of Psychiatry, is the first time music therapy for people with acute schizophrenia has been evaluated.

For this small study, 81 in-patients at four hospitals in central and inner London were randomised to receive music therapy or standard care alone. Those people receiving music therapy had between 8 and 12 sessions, once a week, for up to 45 minutes.

During the sessions patients were given access to a range of musical instruments and encouraged to use them to express themselves. Initially the therapist listened carefully to the patient's music and accompanied them closely, seeking to follow their emotional state in musical terms. The therapist then offered opportunities to extend or vary the nature of the musical interaction.

The researchers measured symptoms of schizophrenia and found that improvements were greater among those people receiving music therapy than among those receiving standard care alone. Referral for music therapy was associated with reductions in general symptoms, such as depression and anxiety, and the negative symptoms of schizophrenia, such as emotional withdrawal. However, the authors caution that because this was a small study, it is possible that other factors, such as severity of illness, may have influenced the study's findings.

Dr Mike Crawford, from the Department of Psychological Medicine at Imperial College London and lead author of the study, said: "We have known for some time that psychological treatments can help people with schizophrenia, but these have only been used when people are fairly stable. This study shows that music therapy provides a way of working with people when they are acutely unwell.

"At such times patients may find it difficult to express themselves using words, but through the skill of the therapist it may be possible to help people interact through music in a way that is constructive, creative and enjoyable," he added.

The researchers believe that the study provides sufficient evidence to justify a larger explanatory randomised trial of music therapy for people with schizophrenia, designed to explore the effects and cost-effectiveness of this kind of therapy.

Dr Crawford explained: "In-patient treatment is the form of care that people with schizophrenia are least satisfied with. Music therapy may provide a means of enhancing the effectiveness of in-patient treatment by reducing some of the symptoms of schizophrenia that respond least well to drug treatment."

Citation: "An exploratory randomised controlled trial of music therapy for inpatients with schizophrenia" British Journal of Psychiatry, 1 November 2006

Source: Imperial College London